Charles Bock - Alice & Oliver

Carmen told her that God understands a white lie. Sometimes you have to do it. They can’t kick him out — goes against the oath.

The mom and her boy ended up at Sinai ER, telling the admit staff his story, his symptoms, everything that Carmen said to tell them. And wouldn’t you know, their story got the emergency doctors listening. The doctors administered all the tests his momma had hoped for. And those tests led the boy to a stomach specialist. Finally, after all this time, he got to deal with someone with expertise. When the specialist heard their story, he got concerned. He did tests. Boom — abscess lining his kidney. Monster size. All sorts of toxic bile in there. But before they could start doing anything about the abscess, they had to pump his belly. They put the kid on IVs. His third day in the hospital bed, he broke down. Tears streamed down his face. I’m hungry, he told his mom, I’m actually hungry .

“Lie as still as you can,” Eisenstatt said.

“It’s cold,” answered Alice.

“Nurse, more blankets.”

“Blankets, Doctor.”

“Before we start,” Alice said. “If you could please — could you explain to me what you are doing, during the procedure, what phase we’re at?”

“I’ll do what I can.”

“Kindly appreciated.”

“What we’re going to do is start at the area near the top of the back of the hip bone, the posterior iliac crest. It’s our entry point. Still, please.”

“Mmm.”

“This is lidocaine. A local anesthetic. You’ll feel a little pinch.”

“Nnn.”

“More lidocaine,” Eisenstatt said. “Now we’re going deeper.”

“Ah. Ah. Ah.”

“There. Let’s let that sit.” The doctor waited. “Please, if you can remain still.”

“I’m trying.”

(Stray odd sounds; the click of a vial twisting and popping open.)

“I think these are extra.”

“Yes, Doctor.”

“Do you have yellow?” he said.

“I’ll get some,” answered the nurse.

“Great. Okay. Okay.”

(Faint scratches. Metal objects impacting metal. Echoes in a pan.)

“Okay?” said the doctor. “How you doing, Mrs. Culvert? Are you doing okay?”

Her answer was a light sob, a whispered chant: Shamalam. Accept .

—

Oliver eventually found the M bank of elevators, the stroller wheels jiggling over the slightly raised grooves when the door slid open. His luck held and the child remained comatose in the lobby during the wait. He started perusing an unattended issue of Schlep, enjoyed the cover story (“Venice: You Mean I’m Supposed to Get Around in a Kayak?”), as well as the little gray sidebar infographic (“And the Smell!”). The office door opened. A woman in a heavy, formless coat came out, followed by a tallish young man. He was pale, moving creakily, and so skinny that his powder-blue sweater engulfed him, the letters of its white TAR HEELS logo folding onto one another. The woman was cursing the office, wondering how could they expect her to get this kind of money? When she saw Oliver and the carriage, she went silent. Her son took her hand. Which of them led the other away was unclear.

Within minutes, Oliver was summoned by the same youngish financial aid woman as earlier, Miss Culpepper, who smiled that same politely annoying smile, and casually guided him into that same sparse cubicle, where she informed Oliver that because of the low ceiling on their family insurance policy, a hold had been placed on his wife’s patient status.

Oliver tamped down on his rage. He had a role — in doctor meetings, this meant asking follow-up questions about side effects, getting clarifications without being obnoxious. Keeping his opinions to himself. For Alice, he swallowed and shut up. So now he kept his voice low and respectful, and explained out a piece of first-grade math.

“I checked with Unified on Friday. Our policy cap is three hundred thousand. We’re around one fifty, is what they told me.”

A finger gracelessly hit what sounded to Oliver like the return key.

“Your wife has leukemia?” Miss Culpepper’s voice was disinterested. She pounded the key a few more times. “We have here her needing a bone marrow transplant? Bone marrow transplant’s a major procedure.”

“That’s months away. You can appreciate — we aren’t close to that point.”

“Transplant costs more than what your whole policy covers.”

Taking a moment, giving his best, most apologetic, most adult, taking-you-in-my-confidence look, he explained to Miss Culpepper about the small policy they’d basically gotten for Alice’s pregnancy, how they should be able to transfer to another policy without hitting any rigmarole about preexisting conditions. He’d checked into all this, he said. He wasn’t looking for pity: “But while I’m figuring out our best next step, if we’re months away from even approaching our cap, I guess what I’m asking is: Why can’t we just keep using the policy we have?”

Her eyes had glazed. “I can respect your situation, Mr. Culverts. I hope you can respect ours.”

Oliver squirmed in place, decided to not correct her about his last name.

“Hospital procedure,” she continued. “Once you reach a certain level on your insurance coverage, we flag your status.”

“We’re not even —”

Yet again he caught himself. Behind him, though, damage had been done: the baby carriage stirring, minor tremors followed by calm, silence. A near miss. Oliver’s panic about the child awakening receded. He jutted in his chair now, whispering across the desk with the fervor of a person whose spouse’s life depended on him being understood: “We still have one. Hundred and. Fifty. THOUSAND dollars. Alice was in the hospital for thirty-four days in New Hampshire and we didn’t spend that much.”

“I’m sure you can appreciate, billing rates are a little different here in the Upper East Side.”

“Look, you really want to get into this, you want to get into specifics? Okay, say Unified has their way, just say we lose the appeal—”

“Mr. Culverts—”

“More of that billing’s going to be classified out-of-network. It’ll be a hit for me, a massive hit, fine, but it actually comes OFF our policy total of spent insurance money. We’ll end up being MORE under the cap.”

“I’d appreciate it if you please didn’t raise your voice at me, Mr. Culverts.”

“I’m WHISPERING.”

“I’m not raising my voice at you, am I, Mr. Culverts? I’m not losing my temper at you. ”

“ I’m not losing my temper at YOU, either, Miss Culpepper. If I’m upset, which I’m not, but if I am, my upset is not because I have anything against you, I don’t. It’s you as the de facto representative of a bureaucratic nightmare that’s creating all this BULLSHIT —”

“So you’re screaming now?”

“—instead of doing what it should be doing, which is to make sure my wife stays alive .”

“This hospital’s run by a private management company, okay ? This management company, they has they own policies, okay ? End of the day, I don’t make policy. My job, I make sure the hospital gets paid for the services it provide, okay? That ain’t me, that’s policy. If you need, we got all kinds of financial aid and payment options to our patients. I’ll give you the form.”

“Miss— Where…How do I…” Oliver reset himself. “I have a little software business. That’s what I do, Miss Culpepper. It’s not big, I’m the only full-timer. But when I hand in the tax forms for any financial aid papers, it looks like we’re loaded, like that lump is the business’s regular yearly income. Really, it’s all the money to get through development and onto the market.”